HomeMy WebLinkAboutAffidavit of legal interest V1 (2)APPROVED
)A:E 03/02/22
;IJ NUMBR R FP-zo21-57
COUNTY OF ADA
AFFIDAVIT OF LEGAL INTEREST
[.d &r 2L C
(name)
(city)
heing first duly sworn upon, oath, depose and say:
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(address)
�Uwa art
(state)
That I am the record owner of the property described on the attached, and I grant my
permission to:
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(name (address)
to submit the accompanying application(s) pertaining to that property.
I agree to indemnify, defend and hold the City of Meridian and its employees harmless
from any claim or liability resulting from any dispute as to the statements contained
herein or as to the ownership of the property which is the subject of the application.
I hereby grant permission to City of Meridian staff to enter the subject property for the
purpose of site inspections related to processing said application(s).
Dated this ,S day of Ud -- _— _ _, 20
(Signature)
SUBSCRIBED AND SWORN to before me the day and year first about wr' ten.
LEILANI GAMBOA (No ary Public forte)
NOTARY PUBLIC (� Q �p I rn )
STATE .0 NEVAD-109fA 30l Y LIB N u Ill, `,y V �1I
*my
APPT. XPIREr10Y28,2 Residing at: APPT. EXPIRES MAY 28 2023
My Commission Expires: an
( Re% 05 21) '01